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   Explain the two types of order and the
    responsibilities in carrying out order
   List and elaborate the 6 right of administering
    medication
   Identify the do and don’t in administering
    medication
   Identify the common abbreviation when
    administering medication
   Discuss the important consideration of
    medication administration
   Practice the right technique in administering
    medication by following the 6 rights
   Drug(pharmacological definition):

    A chemical substance administered
    for the diagnosis, cure, treatment,
    relief or prevention of disease. Used
    to otherwise enhance physical or
    mental well-being
   Drug administration is very important and
    can be a dangerous duty
    › Given correctly – restore patient to
      health
    › Given incorrectly – patient’s condition
      can worsen
Nurses must:

› Understand principles of pharmacology
› Understand fundamentals of drug
  administration
   Routes
   Dosage calculations
   Techniques for injection
   Six rights
   Patient education
   Standing Order- it is carried out until the
    specified period of time or until it is
    discontinued by another order.

   Single Order- it is carried out for one time only.

   Stat Order- it is carried out at once or
    immediately.

   PRN Order- it is carried out as the patient
    requires.
   1. Observe the “6 Rights” of drug
    administration.
    › 1. Right drug
    › 2. Right dose
    › 3. Right time
    › 4. Right route
    › 5. Right patient
    › 6. Right documentation
 2. Practice asepsis
 3. Nurses who administer medications
  are responsible for their own actions.
  Question any order that you consider
  incorrect.
 4. Be knowledgeable about medications
  that you administer.
 5. keep narcotics and barbiturates in
  locked place.
 6. Use only medications that are clearly
  labeled containers in.
 7. Return liquid that are cloudy or have
  changed in colour to the pharmacy
 8. Before administering a
  medication, identify the client correctly.
 9. Do not leave the medications at the
  bedside.
 10. If the client vomits after taking oral
  medication, report this to the nurse in
  charge and/or physician.
Identify the drug from the Dr.’s order. Clarify
  with the Dr. if in doubt.

  Check the drug three times:
   - before removing it from the trolley or shelf
   - when the drug is removed from the container
   - before the container is returned to storage
   - check the expiry date of the drug

Check the drug with another RN for DDA &
  barbiturate.
 The nurse should be familiar with the
  generic drug name as well as the trade
  name.
 The use of generic name in clinical
  practice is preferred to reduce the risk of
  medication errors.
-    Check the dose, read the container
     label, calculate the dose & check
     with a RN if necessary.

    - Use proper measuring devices for
      liquids, do not crush tablets or open
      capsules unless directed to by the
      pharmacist. (do not crush enteric
      coated tablets).
   If a drug is required in another form you
    may get it from the pharmacy.


   Pediatric & elderly more sensitive to
    medications – need extra caution with
    drug dosage.
   For routine medication orders, the
    medications must be given no more than
    30 min before or after the actual time
    specified in the prescriber’s order.
    E.g., 9.00am med, may be given between
    8.30am-9.30am.

   The effect of changing in dosing or timing
    of medication should never be
    underestimate because one missed dose of
    certain medication can be life threatening.
   Other factors must be considered when
    determining the right time e.g., multiple
    drug therapy, drug-drug or drug-food
    compatibility, scheduling of diagnostic
    studies, bioavailability of drug (e.g., the
    need for consistence timing of doses
    around the clock to maintain blood
    levels), drug actions, and any biorhythm
    effects such as occur with steroids.
   Oral Route Forms: a) solid: tablet, capsule, pill,
    powder.

   b) liquid: syrup, suspension, emulsion.

   Enteric coated tablets should not be crushed
    before administration. Suspensions are never
    administered intravenously. If the patient
    vomits within 20 – 30mins of taking the drugs,
    notify the physician. Do not readminister the
    drug without a physicians order.

 2. Sublingual- drug placed under the
  tongue, where it dissolves.
 3. Buccal- medication is held in the mouth
  against the mucous membranes. of the
  cheek until the drug dissolves.
 4. Topical a) Dermatologic-
  lotions, liniments, ointment, pastes and
  powders. b) Ophthalmic- instillations and
  irrigations. c) Otic, d) Nasal, e) Inhalation, f)
  Vaginal-
  tablet, cream, jelly, foam, suppository
 5. Rectal- (objectionable taste or odor)
18
   6. Parenteral- administration of medications by
    needle.
   a) Intradermal (ID)- under the epidermis (into the
    dermis).
    b) subcutaneous (SC)- in the subcutaneous
    tissue (also, hypodermic)
    c) intramuscular (IM)- into the muscle.
   d) intravenous (IV)- into a vein.
   e) intraarterial- into an artery.
    f) intraosseous- into the bone.
› Checking the pt’s identity before giving
  each medication dose is critical to the
  pt’s safety.
› Ask the patient to state his/her name and
  check his ID band to confirm pt’s
  name, ID number, age, and allergies
  against the medication chart.
 Documentation of information r/to
  administrations is crucial to pt safety.
 The pt’s chart should always have the
  following:
    › Date & time of the medication administered
    › Name of medication, dose, route & site of
      administration.
    › Drug action – to assess the changes of
      symptoms the pt experiencing, adverse
      effects, toxicity & other drug-related physical
      & physiologic symptoms.
 Improvement of the pt’s
  condition, symptom, disease process.
 No changes/lack of improvement.
 Patient’s teaching/degree of pt’s
  understanding.
   Other info:
    › if a drug not administered & reason why?
    › Refusal of a medication & reason for refusal.
    › Actual time of drug administration
    › Data regarding clinical observations &
      treatment of the pt if a medication error has
      occurred.
Drugs can have three types of names:

a. chemical
b. generic
c. trade/brand/proprietary
a.Chemical name:

- a very precise description of the drug’s
  chemical composition, identifying the
  drug’s atomic and molecular structure.
 - this name is of significance to the
  pharmacist.
b. Generic name:

- The name assigned by the
 manufacturer who first develops the
 drug. Often the generic name is derived
 from the chemical name.

- the official name is the name by which
  the drug is identified in the official
  publication.
c.Trade/ Brand/ Proprietary name:

- Is selected by the drug company
 selling the drug and is copyrighted

- a drug can have several trade names
 when produced by different
 manufacturers
e.g. Chemical name= Acetylsalicylic acid
 Generic name = Aspirin
Trade names include Aspro, Disprin

Be aware that in different countries
generic and trade names will also differ,
e.g. in Australia & the United States one
drug has the generic names of
paracetamol & acetaminophen, i.e.
Panadol/Tylenol.
Drugs can be classified from different
   perspectives
e.g. drugs may be classified by -
(a) body systems
  i.e. drugs affecting the respiratory system
      drugs affecting the cardiovascular system
     OR
(b) the symptom relieved by the drug, or the
   clinical indication for the drug i.e. analgesic,
   antibiotic
 MANE       morning
 MIDI       midday
 NOCTE      Night

 BD/BID     twice a day
             three times a day
 TDS/TID
             four times a day
 QID
             give immediately
 STAT
             when required
 PRN         when necessary
 ac             before meals
 Pc             after meals
 q.h.or1/24     every hour
 q2h or 2/24    every two hours
 q4h or 4/24    every four hours
 qod            Every other day
   BUC      inside cheek
   O/P.O    oral/per oral
   S/L      sublingal
             (under the tongue)
   ID       intradermal
   IM       intramuscular
   SC/SQ    subcutaneous
   SCI      subcutaneous
              injection
   IVI      intravenous injection
   IVT      intravenous therapy

   NEB      nebuliser
   PR       per rectum
   TOP      topical/skin
   VAG      vaginal
   Rx           Prescribe, take
   NPO/NBM      Nil per oral/nil by
                  mouth
6 rules of drug administration

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6 rules of drug administration

  • 1.
  • 2. Explain the two types of order and the responsibilities in carrying out order  List and elaborate the 6 right of administering medication  Identify the do and don’t in administering medication  Identify the common abbreviation when administering medication  Discuss the important consideration of medication administration  Practice the right technique in administering medication by following the 6 rights
  • 3. Drug(pharmacological definition): A chemical substance administered for the diagnosis, cure, treatment, relief or prevention of disease. Used to otherwise enhance physical or mental well-being
  • 4. Drug administration is very important and can be a dangerous duty › Given correctly – restore patient to health › Given incorrectly – patient’s condition can worsen
  • 5. Nurses must: › Understand principles of pharmacology › Understand fundamentals of drug administration  Routes  Dosage calculations  Techniques for injection  Six rights  Patient education
  • 6. Standing Order- it is carried out until the specified period of time or until it is discontinued by another order.  Single Order- it is carried out for one time only.  Stat Order- it is carried out at once or immediately.  PRN Order- it is carried out as the patient requires.
  • 7. 1. Observe the “6 Rights” of drug administration. › 1. Right drug › 2. Right dose › 3. Right time › 4. Right route › 5. Right patient › 6. Right documentation
  • 8.  2. Practice asepsis  3. Nurses who administer medications are responsible for their own actions. Question any order that you consider incorrect.  4. Be knowledgeable about medications that you administer.  5. keep narcotics and barbiturates in locked place.  6. Use only medications that are clearly labeled containers in.
  • 9.  7. Return liquid that are cloudy or have changed in colour to the pharmacy  8. Before administering a medication, identify the client correctly.  9. Do not leave the medications at the bedside.  10. If the client vomits after taking oral medication, report this to the nurse in charge and/or physician.
  • 10. Identify the drug from the Dr.’s order. Clarify with the Dr. if in doubt. Check the drug three times: - before removing it from the trolley or shelf - when the drug is removed from the container - before the container is returned to storage - check the expiry date of the drug Check the drug with another RN for DDA & barbiturate.
  • 11.  The nurse should be familiar with the generic drug name as well as the trade name.  The use of generic name in clinical practice is preferred to reduce the risk of medication errors.
  • 12. - Check the dose, read the container label, calculate the dose & check with a RN if necessary. - Use proper measuring devices for liquids, do not crush tablets or open capsules unless directed to by the pharmacist. (do not crush enteric coated tablets).
  • 13. If a drug is required in another form you may get it from the pharmacy.  Pediatric & elderly more sensitive to medications – need extra caution with drug dosage.
  • 14. For routine medication orders, the medications must be given no more than 30 min before or after the actual time specified in the prescriber’s order. E.g., 9.00am med, may be given between 8.30am-9.30am.  The effect of changing in dosing or timing of medication should never be underestimate because one missed dose of certain medication can be life threatening.
  • 15. Other factors must be considered when determining the right time e.g., multiple drug therapy, drug-drug or drug-food compatibility, scheduling of diagnostic studies, bioavailability of drug (e.g., the need for consistence timing of doses around the clock to maintain blood levels), drug actions, and any biorhythm effects such as occur with steroids.
  • 16. Oral Route Forms: a) solid: tablet, capsule, pill, powder.  b) liquid: syrup, suspension, emulsion.  Enteric coated tablets should not be crushed before administration. Suspensions are never administered intravenously. If the patient vomits within 20 – 30mins of taking the drugs, notify the physician. Do not readminister the drug without a physicians order. 
  • 17.  2. Sublingual- drug placed under the tongue, where it dissolves.  3. Buccal- medication is held in the mouth against the mucous membranes. of the cheek until the drug dissolves.  4. Topical a) Dermatologic- lotions, liniments, ointment, pastes and powders. b) Ophthalmic- instillations and irrigations. c) Otic, d) Nasal, e) Inhalation, f) Vaginal- tablet, cream, jelly, foam, suppository  5. Rectal- (objectionable taste or odor)
  • 18. 18
  • 19. 6. Parenteral- administration of medications by needle.  a) Intradermal (ID)- under the epidermis (into the dermis).  b) subcutaneous (SC)- in the subcutaneous tissue (also, hypodermic)  c) intramuscular (IM)- into the muscle.  d) intravenous (IV)- into a vein.  e) intraarterial- into an artery.  f) intraosseous- into the bone.
  • 20. › Checking the pt’s identity before giving each medication dose is critical to the pt’s safety. › Ask the patient to state his/her name and check his ID band to confirm pt’s name, ID number, age, and allergies against the medication chart.
  • 21.  Documentation of information r/to administrations is crucial to pt safety.  The pt’s chart should always have the following: › Date & time of the medication administered › Name of medication, dose, route & site of administration. › Drug action – to assess the changes of symptoms the pt experiencing, adverse effects, toxicity & other drug-related physical & physiologic symptoms.
  • 22.  Improvement of the pt’s condition, symptom, disease process.  No changes/lack of improvement.  Patient’s teaching/degree of pt’s understanding.
  • 23. Other info: › if a drug not administered & reason why? › Refusal of a medication & reason for refusal. › Actual time of drug administration › Data regarding clinical observations & treatment of the pt if a medication error has occurred.
  • 24. Drugs can have three types of names: a. chemical b. generic c. trade/brand/proprietary
  • 25. a.Chemical name: - a very precise description of the drug’s chemical composition, identifying the drug’s atomic and molecular structure. - this name is of significance to the pharmacist.
  • 26. b. Generic name: - The name assigned by the manufacturer who first develops the drug. Often the generic name is derived from the chemical name. - the official name is the name by which the drug is identified in the official publication.
  • 27. c.Trade/ Brand/ Proprietary name: - Is selected by the drug company selling the drug and is copyrighted - a drug can have several trade names when produced by different manufacturers
  • 28. e.g. Chemical name= Acetylsalicylic acid Generic name = Aspirin Trade names include Aspro, Disprin Be aware that in different countries generic and trade names will also differ, e.g. in Australia & the United States one drug has the generic names of paracetamol & acetaminophen, i.e. Panadol/Tylenol.
  • 29. Drugs can be classified from different perspectives e.g. drugs may be classified by - (a) body systems i.e. drugs affecting the respiratory system drugs affecting the cardiovascular system OR (b) the symptom relieved by the drug, or the clinical indication for the drug i.e. analgesic, antibiotic
  • 30.  MANE  morning  MIDI  midday  NOCTE  Night  BD/BID  twice a day  three times a day  TDS/TID  four times a day  QID  give immediately  STAT  when required  PRN when necessary
  • 31.  ac  before meals  Pc  after meals  q.h.or1/24  every hour  q2h or 2/24  every two hours  q4h or 4/24  every four hours  qod  Every other day
  • 32. BUC  inside cheek  O/P.O  oral/per oral  S/L  sublingal (under the tongue)  ID  intradermal  IM  intramuscular  SC/SQ  subcutaneous
  • 33. SCI  subcutaneous injection  IVI  intravenous injection  IVT  intravenous therapy  NEB  nebuliser  PR  per rectum  TOP  topical/skin  VAG  vaginal
  • 34. Rx  Prescribe, take  NPO/NBM  Nil per oral/nil by mouth